Once in a while you come across an interesting article which looks at re-purposing an existing medication for a new indication. For example, a while back I blogged about how the topical beta blocker timolol could be used to treat heel fissures. For those with longer memories there was a lot of interest in the a gastric ulcer drug cimetidine which showed promise in clearing cutaneous warts [1] but latterly failed to show effectiveness clinically due to the high dosage required and side effects. A while back I also mentioned the antifungal effects of statins in an earlier blog so I decided to d ..read more

Pigmented lesions on the skin can often look similar – brown in colour and usually flat. A common question is what are freckles? This blog investigates. Freckle is the common term encompassing both ephelides (freckles) and lentigines (often referred to as liver spots). The two similar in many ways but are effectively different diagnoses. Where do they arise from? The main pigment producing cell of the skin is the melanocyte which produces melanin in an intra-cellular organ known as a melanosome. During embryotic development, melanocytes arise from the neural crest as melanoblasts and m ..read more

I always remember a lecture I heard a few years ago which suggested that “food” is best eaten and should not be put in moisturisers and this principle was reiterated at a recent lecture on atopic dermatitis I attended, exploring the link between atopic dermatitis and food allergy. Around the world, a lot of natural food oils have been shown to have beneficial effects to improving the skin barrier function and moisturisation [1]. Atopic dermatitis is a very common inflammatory skin condition which can develop in infancy leading to flares and itching. The use of use of natural oils by some ma ..read more

On my blog I have written much about the benefits of emollients over the years. They are the mainstay of treatment in dermatology in maintaining skin integrity and health for a range of dermatoses. Regular application can increase the skins flexibility, suppleness and prevent complications such as drying and fissuring. Their benefits are exemplified in conditions such as atopic eczema where emollients can reduce inflammation [1], itching and erythema but are there any other benefits? Two recent papers have investigated tinea pedis and its recurrence, suggesting additional benefits of regular ..read more

Melanoma is the most common primary malignancy arising on the foot [1]. The location has been noted in a number of studies to hold a worse prognosis compared to lesions elsewhere on the body [2] often due advanced disease at diagnosis [3, 4]. It is likely that the time factor is key here - the time taken to reach a diagnosis depends on the patient's ability to recognise and seek professional advice. Delay in diagnosis Secondly, diagnosis depends on the professional's capacity to recognise the lesion. Melanoma on the feet are often presented later to clinicians than melanoma elsewhere. Data wer ..read more

I have covered dermoscopy as a topic for many years on my blog. Three and a half years ago, I reviewed ,,Heine’s Delta 30 dermatoscope and have continued to use it as my main dermatoscope in day-to-day practice.  This week I was lucky enough to acquire the latest product from this renowned German brand - the HEINE DELTA 30 Pro. In this blog I will be taking a first look at their new flagship device. What's in the box? The DELTA 30 Pro is best described as an enhancement of the existing DELTA 30. Opening the box reveals a similar black hard case - slimmer than its predecessor containing t ..read more

Melanonychia is the term used to describe any brown/black discolouration of the nail. Most often, it presents as a longitudinal band running from the cuticle to the free edge of the nail [1]. It has many causes but rarely it may be a result of a malignant process such as melanoma. For the clinician, diagnosis can be difficult. In the foot, friction and trauma are often overlooked as frequent causes of pigmented nail bands - as this blog explores. Longitudinal melanonychia is frequently a cause for concern for podiatrists when confronted with it in the clinic but it is important to stress it ha ..read more

A live online course for podiatrists & healthcare professionals Delivered in sessions of one hour over four weeks on Zoom Monday 22nd January 8pm - 9pm Monday 29th January 8pm - 9pm Monday 5th February 8pm - 9pm Monday 12th February 8pm - 9pm Do you want to get more people to your website and generate more business? Do you want to be seen as a trusted expert and help people understand the need for proper footcare? Do you want to use your time and resources more effectively? Whether you already post blogs and want to increase the traffic you’re getting, or you would like to start a practice ..read more

Case Outline A 71-year-old white male presented for an assessment at the podiatry clinic describing “a painful corn under his right foot”. He was examined by the podiatrist who noted an unusual vascular lesion / ulcer distal to the metatarsal head on the plantar surface. The patient had no recollection of how long the lesion had been present and denied any pain from the lesion. The podiatrist initially suspected a foreign body and planned a review in two weeks, with a view to a second opinion if was no better at the next appointment. In the following fortnight, no improvement was noted, and a ..read more

In 2021, I wrote a blog highlighting the growing problem of dermatophyte resistance. In the post I discussed the emerging cases from the Asia which have surfaced in the literature of dermatophytes not responding to regular antifungal agents with one study in 202 showing 71% of dermatophyte samples collected in India showing terbinafine resistance (1). A recent headline in the Mail on Sunday highlights the effects to public health explaining how antifungal creams soon may not work as well as they did as resistant fungal strains emerge. Media scaremongering? So, what has been developing since my ..read more